april 28, 2016 learningreflectionppt.pdfthe other culture. •tolerates different views, values...

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2016 LEARNING AND REFLECTION FORUM SERIES

Cultural Brokering: An Effective Approach for Engaging Diverse Communities in Intellectual and Developmental

Disabilities (IDD) Services and Supports

April 28, 2016

Tawara D. GoodeGeorgetown University National Center for Cultural Competence

University Center for Excellence in Developmental Disabilities Center for Child and Human Development

Paula SotnikInstitute for Community Inclusion, School for Global Inclusion & Social Development

University of Massachusetts Boston

Tracy BeardTennessee Disability Pathfinder

Vanderbilt Kennedy Center for Excellence in Developmental Disabilities

Oahn BuiFederation for Children with Special Needs

Diversity Leadership Fellow, Institute for Community InclusionUniversity Center for Excellence in Developmental Disabilities

FORUM PRESENTERS

Slide Source:© 2016 - Georgetown University National Center for Cultural Competence

http://nccc.georgetown.edu/leadership/index.html

http://nccc.georgetown.edu/leadership/index.html

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FORUM OBJECTIVES



Framing the

Concepts

CULTURALBROKERING

An Effective Intervention for Culturally

Diverse Communities

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Concept of Cultural Brokering

The act of bridging, linking or mediating between groups or persons of different cultural backgrounds for the purpose of reducing conflict or producing change.

Source: Jezewski, M. (1990). Culture brokering in migrant farmworker health care. Western Journal of Nursing Research, 12(4), 497-513.


Definition of Cultural Broker

a go-between, one who advocates

on behalf of an individual or group

Data Source: Jezewski, M. A., & Sotnik, P. (2001). Culture brokering: Providing culturally competent rehabilitation services to foreign-born persons. (J. Stone, Ed.). Buffalo, NY: Center for International Rehabilitation Research Information and Exchange.

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Who is the Cultural Broker?

Data Source: National Center for Cultural Competence (2005). Bridging the cultural divide in health care settings: the essential role in culture broker programs. Washington, DC: Georgetown University Center for Child and Human Development.

liaison

cultural guide

mediator

catalyst for change


Adapted from: National Center for Cultural Competence (2005). Bridging the cultural divide in health care settings: the essential role in culture broker programs. Washington, DC: Georgetown University Center for Child and Human Development.

trust & respect of the community

knowledge of values and belief systems of diverse racial, ethnic, and cultural groups about disability

understanding of traditional & indigenous networks of support within diverse communities

experience navigating disability, health, behavioral health, education, and other systems

Characteristics & Attributes of a Cultural Broker

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Data Source: National Center for Cultural Competence (2005). Bridging the cultural divide in health care settings: the essential role in culture broker programs. Washington, DC: Georgetown University Center for Child and Human Development.

Cultural brokering … honors & respects cultural differences within communities

is community-driven

is provided in a safe and non-judgmental manner

involves service delivery that is accessible & tailored to communities served

acknowledges reciprocity & transfer of assets between community and service agencies

Guiding Principles for Cultural Broker Programs


Key Strategies and Approaches for Engaging Diverse Communities

Learn about communities.

Enter communities respectfully.

Elicit and consider the interests and needs of communities before declaring the goals of your program.

Data source: Goode & Jackson, 2010

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Explore areas of mutual interests and benefits.

Foster relationships and partnerships that are built on mutual trust, reciprocity, and respect.

Commit to the long-haul.

Data source: Goode & Jackson, 2010

Currently does your organization or setting have:

Staff whose positions formally includes the role of cultural brokering? Yes No Don’t Know

People with intellectual and developmental disabilities serving as cultural brokers? Yes No Don’t Know

A formally designated cultural broker program? Yes No Don’t Know

POLLING QUESTION

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Institute for Community Inclusion and School of Global Inclusion and Social Development

University of Massachusetts Boston

A Cultural Brokering Model:

Adapted to Ensure Culturally Competent Supports for Foreign-born Individuals with Disabilities

Paula Sotnik

[email protected]

Culture Brokering

• In 1998, Mary Ann Jezewski, a nurse and anthropologist at the University of Buffalo, originally developed a theoretical model of culture brokering in the health services.

• This model was then adapted by Paula Sotnik to develop culturally competent supports for foreign-born individuals with disabilities by US rehabilitation systems. Publications and a curriculum were also developed.

Sotnik, P; Jezewski, M.A. (2005). Culture and Disability. In J.H. Stone (Eds)., Culture and disability : Providing culturally competent services. Thousand Oaks: SAGE Publications.

Jezewski, M.A, Sotnik, P. (2001) Culture Brokering: Providing Culturally Competent Rehabilitation Services to Foreign-Born Persons. Center for International Rehabilitation Research Information and Exchange. CIRRIE Monograph Series.

http://cirrie.buffalo.edu/culture/monographs/cb.php

mailto:[email protected]

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Culture Brokering

The act of bridging, linking or mediating between groups or persons of differing cultural systems to prevent or reduce conflict or produce change.

Culture Broker:

•Functions as a “cultural bridge” between diverse

communities and mainstream service systems

•Understands how a diverse community’s culture

differs from the mainstream service system’s

culture

•Can explain nuances & values of one culture to

the other culture.

•Tolerates different views, values & beliefs

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Culture Brokering Model

Adapted from Jezewski, M.A. (1995), Evolution of a grounded

theory: Conflict resolution through culture brokering. Advances in Nursing Science. 17(3), 14-30.


Intervening Conditions

1.Student is from a very traditional Nepali family.

2.University has a Nepali student population.

3.Professor talked to the student regarding reasonable accommodations for students who may have difficulties learning.

4.Student remembers a village member who could not walk and was “transported to another country to beg.”

5.Student never heard the term “learning disability.”

6.The Institute for Asian American Studies at UMASS is knowledgeable and sensitive to cultural issues of disability. Has many connections to Asian CBO’s.

STAGE 1 – Conflict

Following a meeting with his professor, a student is referred to the Student Disability Office and agrees to an appointment. He does not show up for his appointment and does not attend his classes.

STAGE 2INTERVENTION•Establishing trust and rapport•Maintaining connectionsSTRATEGIES•Another Asian student with a disability identified through the Disability Office to serve as a mentor.•Asian CBO provides culturally responsive disability training to faculty.•Disability inclusion concepts integrated in Asian courses•Professor visits/meets with Nepali community center in family’s neighborhood, initiated by Institute.

STAGE 3

SUCCESSFUL OUTCOMES•Student starts attending classes. Student receives assistance with learning accommodations from mentor. • Nepali community receives info about “disability” and services through community center.•Faculty receives training on Asian perception of disability from InstituteRESOLUTION

or LACK OF RESOLUTION

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Disability

Communication

Age

Culture Sensitivity

Time

Cultural Background

Gender

Education

Power/Powerlessness

Economics

Bureaucracy

Politics

Networks

Stigma

Stage 1

PerceptionPerception of the need for brokering

Conflict, breakdowns

ProblemsBarriers to access and utilization

Breakdowns in connections

Now being viewed and used as a more proactive strategy

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Stage 2

Intervention

Establishing trust and rapport

Maintaining connections

Strategies

Linking through:

advocating negotiating

intervening sensitizing

networking innovating mediating educating

Stage 3

Outcome:

ResolutionEstablished connections between individuals and the service systemMaintaining facilitation across systems

OR

Lack of ResolutionContinued breakdown/conflict

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Adapted from Jezewski, M.A. (1995), Evolution of a grounded

theory: Conflict resolution through culture brokering. Advances in Nursing Science. 17(3), 14-30.



1.Student is from a very traditional Nepali family.

2.University has a Nepali student population.

3.Professor talked to the student regarding reasonable accommodations for students who may have difficulties learning.

4.Student remembers a village member who could not walk and was “transported to another country to beg.”

5.Student never heard the term “learning disability.”

6.The Institute for Asian American Studies at UMASS is knowledgeable and sensitive to cultural issues of disability. Has many connections to Asian CBO’s.

STAGE 1 – Conflict

Following a meeting with his professor, a student is referred to the Student Disability Office and agrees to an appointment. He does not show up for his appointment and does not attend his classes.

STAGE 2INTERVENTION•Establishing trust and rapport•Maintaining connectionsSTRATEGIES•Another Asian student with a disability identified through the Disability Office to serve as a mentor.•Asian CBO provides culturally responsive disability training to faculty.•Disability inclusion concepts integrated in Asian courses•Professor visits/meets with Nepali community center in family’s neighborhood, initiated by Institute.

STAGE 3

SUCCESSFUL OUTCOMES•Student starts attending classes. Student receives assistance with learning accommodations from mentor. • Nepali community receives info about “disability” and services through community center.•Faculty receives training on Asian perception of disability from InstituteRESOLUTION

or LACK OF RESOLUTION

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Attributes of a Culture Broker

A willingness to be a risk taker

Able to tolerate ambiguous roles

Comfortable functioning at the margins of various systems (the person’s cultural system and the service delivery system.)

Good communication skills

Attributes of a Culture Broker

The ability to network

Effective problem solving skills

Flexibility and a willingness to learn and perfect the culture brokering role

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Thank You!

For further information, please feel free to contact us:

Paula Sotnik

[email protected]

617 590 – 6409

For further reading and resources, please see:

www.serviceandinclusion.org/culturebrokering/

www.serviceandinclusion.org

http://InclusiveEvents.org/

https://www.nationalserviceresources.org/expert-sotnik-inclusion

http://www.communityinclusion.org/staff.php?staff_id=38


Cultural Brokering:

Implementing Cultural Brokering:Examples from UCEDD and LEND Programs

Tracy P. BeardVanderbilt Kennedy Center


http://www.serviceandinclusion.org/culturebrokering/

http://www.serviceandinclusion.org/

http://inclusiveevents.org/

https://www.nationalserviceresources.org/expert-sotnik-inclusion

http://www.communityinclusion.org/staff.php?staff_id=38


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Implementing Cultural Brokering: Organizational Self-Assessment

A few questions to consider:

• Identify the community you are serving: – Who are you currently serving? – Are you serving the community effectively? – Who are you not serving? Why?

•Identify barriers:– What are the barriers experienced by the community you are serving? – What are the organizational barriers?

•Identify Goals: – What are the goals of the community?– What are your organizations goals? – Do you share the same goals as the community that you are serving?

Polling QuestionHeading

How often does your organization self-assess the efficacy in serving culturally and linguistically diverse communities?

• My organization often performs self-assessments to measure the efficacy of serving culturally and linguistically diverse communities.

• My organization sometimes performs self-assessments to measure the efficacy of serving culturally and linguistically diverse communities.

• My organization rarely performs self-assessments to measure the efficacy of serving culturally and linguistically diverse communities.

• My organization has never performed a self-assessment to measure the efficacy of serving culturally and linguistically diverse communities.

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Implementing Cultural Brokering: Examples of Tools Used for Organizational Self-Assessment

External Resources:

• The Cultural and Linguistic Competence Assessment for Disability Organizations (CLCADO): Assessment and Guide http://www.gucchdgeorgetown.net/NCCC/CLCADO/

• Census Data - Examine the demographics of Tennessee.

• Immigrant and Refugee Community Organizations Needs Assessments/Annual Reports - Tennessee Immigrant & Refugee Rights Coalition (TIRRC)

Internal Resources: • Impact Survey - an internal reporting tool used to gage the effectiveness and what demographics our programs serve.

• Cultural and Linguistic Readiness Self-Assessment - an internal faculty and staff survey to measure the capacity to serve culturally and linguistically diverse communities.

Identifying Cultural BrokersCultural Brokers may be any of the following:

•Peer Mentor•Community Member•Interpreter•Program Manager•Board Member•Social Worker•Outreach or Program Educator•Administrative Leader

Adapted from Georgetown University Center for Child and Human Development Georgetown University Medical Center.

(2004). Bridging the cultural divide in health care settings: the essential role in culture broker programs. Retrieved from

http://www.culturalbroker.info/Cultural_Broker_EN.pdf

Photo of Community Advocacy Program in front of Springfield Capital

building of the Lake County Center for Independent Living

http://www.gucchdgeorgetown.net/NCCC/CLCADO/


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Identifying Cultural Brokers

Cultural Brokers may work in a various settings:

• Disability-related community organizations• Community-based organizations• Government Organizations• Faith-based organizations• Schools/Universities




Identifying Cultural Brokers: Attributes and Skills

Attributes:

• Assess and understand their own cultural identities and value systems

• Recognize the values that guide and mold attitudes and behaviors• Understand and respect a community's traditional beliefs, values,

practices and changes that occur through acculturation• Understand and practice the tenets of effective cross-cultural

communication (verbal and non verbal nuances)






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Identifying Cultural Brokers: Attributes and Skills

Skills:

• Assessment• Problem-solving • Conflict Resolution• Cross-Cultural

Communication

Adapted from Jezewski M., A., and Sotnik, P. (2005). Disability Service Providers as Culture Brokers. In J.H. Stone

(Eds)., Culture and disability : Providing culturally competent services. Thousand Oaks: SAGE Publications..

Stock photo

Examples of Cultural Brokering

• Cultural broker as a Liaison– Serve as communicators between consumers and

the disability service system– Knowledgeable in two realms:

• The values, beliefs, and practices within their own cultural group or community

• The disability service system that they have learned to navigate either for themselves, their family member, and/or service provider.

Program example: Department of Intellectual and Developmental Disabilities Limited English Proficiency




Stock photo


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• Cultural broker as Cultural Guide– Serve as guides for disability

service that are in the process of incorporating culturally and linguistically competent principles, values, and practices.

• Program example:– LEND Family Trainee




Stock photo


• Cultural broker as a Mediator– Can help to ease the historical

and inherent distrust that communities may feel towards the disability service system

• Program example: – Hispanic Family Foundation




Alexander Santana, Vanderbilt Kennedy Center educating a family on

disability services.



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• Cultural broker as Change Agents – Can initiate transformation within

the disability service system creating an inclusive and collaborative environment for service providers, consumers, and families.

• Program example: – Multicultural Alliance on Disability




Stock photo

Reference Material

Georgetown University Center for Child and Human Development Georgetown University Medical Center. (2004). Bridging the cultural divide in health care settings: the essential role in culture broker programs. Retrieved from http://www.culturalbroker.info/Cultural_Broker_EN.pdf

Jezewski M., A., and Sotnik, P. (2005). Culture and the disability services. In J.H. Stone (Eds)., Culture and disability : Providing culturally competent services. Thousand Oaks: SAGE Publications..

Jezewski M., A., and Sotnik, P. (2005). Disability service providers as culture brokers. In J.H. Stone (Eds)., Culture and disability : Providing culturally competent services. Thousand Oaks: SAGE Publications..



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Contact Information

Tracy P. Beard Vanderbilt Kennedy Center

Email: [email protected]: http://vkc.mc.vanderbilt.edu/vkc/

Vanderbilt Kennedy Center Social MediaTwitter: @Vanderbilt_KC

Facebook: www.facebook.com/VanderbiltKennedyCenter

INFORMING, EDUCATING, EMPOWERING FAMILIES617-236-7210 | www.fcsn.org | [email protected]


http://vkc.mc.vanderbilt.edu/vkc/

http://www.facebook.com/VanderbiltKennedyCenter

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Cultural Brokers: An Effective Approach

for Engaging Diverse Families

© Federation for Children with Special Needs, 2015

The Schrafft Center ● 529 Main Street, Suite 1M3 ● Boston, MA 02129

617-236-7210 ● Toll Free 1-800-33-0688 ● Fax 617-241-0330

Oanh Thi Thu Bui, MA, MHA

Federation for Children with Special Needs

© Federation for Children with Special Needs , 2015

Federation for Children with Special Needs (FCSN)

• Special Education Center: Parent Training & Information Center,

LINK Center

• Family Support Center: Family TIES of Massachusetts,

Pathways For Parents

• Health Care Advocacy Center: Family-to-Family Health Information

Center @ Mass. Family Voices

• Family and Community Engagement Center: FACET, Recruitment,

Training & Support Center for Special Education Surrogate Parents

• Parent-Professional Leadership Center: Advancing Parent-Professional

Leadership in Education, MASSPAC

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My own journey as a cultural broker


Why Are Cultural Brokers Valuable?

• Different cultural values

• Language barriers

• Different disabilities

• Different perspectives about disability

• Complicated support system, including terminology

• Different service delivery across the lifespan

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How FCSN Addresses This Challenge

• Apply the Cultural Broker model by recruiting bilingual/bicultural staff.

• Collaborate with community leaders to:

Identify parent leaders;

Empower them to take the lead in providing support to parents from their own communities;

Help FCSN understand the needs of their communities;

Review training materials to ensure that they are culturally and linguistically appropriate; and

Encourage parents to participate in research.


What Do Cultural Brokers Do?

Collaborate with a family’s interdisciplinary team

– Family Members and Child

– Medical Team

– Educational Team

– Health Insurance Team

– Social and Recreational Team

Support positive outcomes

- Educate and empower Parents

- Collaborate with Professionals (reciprocal and mutual understanding)

- Increase access to services

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• Liaison

• Cultural guide

• Mediator

• Change agent or Catalyst for Change

• Advocate

What Roles Can Cultural Brokers Serve?

Source: National Cultural Competence Center


Increased Contact For Parents And FCSN

– Cultural brokers help increase the frequency of contact of parents with FCSN.

– Families can address all sorts of information, including education, medical needs, and social services.

– One family may easily interact with FCSN staff more than 100 times over the course of one year.

– One family might interact with 3 or 5 different projects at the Federation, depending on their unique needs.

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Number of Diverse Families

Reaching Out To FCSN

The number of parents speaking different languages has

increased from 2013 to 2015:

Chinese: 5 to 78

Portuguese: 9 to 118

Spanish: 21 to 778

Vietnamese: 1 to 73


Story Vignette

• PTI takes a call on behalf of a 17-year-old young man who has been

diagnosed with DiGeorge syndrome and developmental delay: His

family has been in the US for less than 6 years. Mom speaks no English.

• At an IEP meeting with the school district, the Team discussed

transition goals, including skills of independence, employment and

travel training for the youth, as well as guardianship when he turns 18.

• School Team suggested starting to teach the youth to take public

transportation to increase his skills of independence.

• Mom is very scared and emotionally shut down after the meeting.

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ResourcesBridging Cultural Divide in Health Care Settings

http://www.culturalbroker.info/1_overview/index.html

Cultural Competence Standards in Managed Care Mental Health Services: Four Underserved/ Underrepresented Racial/Ethnic Groups http://mentalhealth.samhsa.gov/publications/allpubs/SMA00-3457/preface.asp

Multicultural Support Manual http://www.nami.org/Content/ContentGroups/Multicultural_Support1/AAPIManual.pdf

National Center for Cultural Competence http://www11.georgetown.edu/research/gucchd/nccc/

NCCC Resources on Self-Assessment for Providers http://www11.georgetown.edu/research/gucchd/nccc/information/providers.html

The Provider's Guide to Quality and Culture http://erc.msh.org/mainpage.cfm?file=1.0.htm&module=provider&language=English


Resources

• Chua, Amy. Battle Hymn of the Tiger Mother. (2011)

• Fadiman, Anne. The Spirit Catches You and You Fall Down. (1998)

• Grinker, Roy Richard. Unstrange Minds. (2007)

• Henderson, Bill. The Blind Advantage: How Going Blind Made Me a Stronger Principal and How Including Children with Disabilities Made Our School Better for Everyone. (2011)

• Kalyanpur, Maya, Ph.D. and Harry, Beth, Ph.D. Cultural Reciprocity in Special Education: Building Family-Professional Relationships. (2005)

• Nguyen, Kim Yen. Surviving War, Surviving Autism. (2011)

• Stone, John H. Culture and Disability-Providing Culturally Competent Services. (2004)

http://www.culturalbroker.info/1_overview/index.html

http://mentalhealth.samhsa.gov/publications/allpubs/SMA00-3457/preface.asp

http://www.nami.org/Content/ContentGroups/Multicultural_Support1/AAPIManual.pdf

http://www11.georgetown.edu/research/gucchd/nccc/

http://www11.georgetown.edu/research/gucchd/nccc/information/providers.html

http://erc.msh.org/mainpage.cfm?file=1.0.htm&module=provider&language=English

http://www.amazon.com/s/ref=ntt_athr_dp_sr_2?_encoding=UTF8&field-author=Beth Harry Ph.D.&search-alias=books&sort=relevancerank

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To engage communities successfully, organizations must understand:

their own organizational culture, and the cultures of their personnel;

the diverse cultures represented within the communities they serve or seek to serve;

Adapted from: Goode, T. (2001). Policy Brief 4. Engaging diverse communities to realize the vision of 100% access and 0 health disparities: a culturally competent approach. Washington, DC: National Center for Cultural Competence. Georgetown University Child Development Center.


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To engage communities successfully, organizations must understand:

the social, political, and economic climates of communities within a cultural context;

the inherent ability of communities to recognize their own problems, including the well-being of its members, and intervene appropriately on their own behalf.

Adapted from: Goode, T. (2001). Policy Brief 4. Engaging diverse communities to realize the vision of 100% access and 0 health disparities: a culturally competent approach. Washington, DC: National Center for Cultural Competence. Georgetown University Child Development Center.



Cultural Brokering: Implications for Leaders

A leader is:

someone who shows the way (that is conducts, directs, escorts,

guides, pilots, shepherds, ushers, navigates, steers)

a person who inspires and engenders trust in others

uses and shares power to achieve a desired outcome or goal

conscious and aware of the influence of cultural values, beliefs, and

behaviors both of his or her own and those of others

a person of influence

Use these characteristics

to describe the role of leaders in advancing

cultural brokering

Source: Goode & Jackson, 2010

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Leaders use power in alignment with the values &

principles of cultural and linguistic competence.

Leaders are cognizant of the power and influence

they possess, exercise that power wisely and

respectfully, and use it to achieve organizational

goals for cultural and linguistic competence.

REFLECTION

CONTACT US

National Center for Cultural Competencehttp://nccc.georgetown.edu

[email protected]

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